Hetro Ashely, Rossetto Janel, Bahlawan Nahed, Ryan Margaret
J Am Pharm Assoc (2003). 2015 Jan-Feb;55(1):73-6. doi: 10.1331/JAPhA.2015.14103.
To evaluate the effect of clinical pharmacists embedded in primary care at a military facility by reviewing laboratory assessments following pharmacist management of referred patients with diabetes and hyperlipidemia.
Electronic medical records of patients who were referred to clinical pharmacists for control of diabetes and/or hyperlipidemia were reviewed for those with at least two encounters during a 6-month period with baseline and follow-up laboratory assessments. As appropriate to patient diagnoses, glycosylated hemoglobin (A1C), low density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and body mass index (BMI) were included in assessments. Paired t tests were used to determine the statistical significance of mean changes between the beginning and end of the 6-month period.
In the cohort of patients with diabetes (n = 46), mean A1C decrease over 6 months was 0.9 points (P = 0.004). In the cohort of patients with hyperlipidemia (n = 15), mean LDL-C decrease was 20 mg/dL (P = 0.004). Changes in mean LDL-C, TGs, and BMIs were observed in each group but were not statistically significant.
Although small sample sizes limited statistical power in this analysis, results suggest that referral of ambulatory patients to a clinical pharmacist in a military medical home for diabetes and/or hyperlipidemia improved care management.
通过回顾药师管理的糖尿病和高脂血症转诊患者的实验室评估结果，评估临床药师嵌入军事设施基层医疗的效果。
回顾因糖尿病和/或高脂血症控制而转诊至临床药师处的患者的电子病历，选取在6个月期间至少有两次就诊且有基线和随访实验室评估的患者。根据患者诊断情况，评估中纳入糖化血红蛋白（A1C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TGs）和体重指数（BMI）。采用配对t检验确定6个月期间开始和结束时平均变化的统计学意义。
在糖尿病患者队列（n = 46）中，6个月内平均A1C下降0.9个百分点（P = 0.004）。在高脂血症患者队列（n = 15）中，平均LDL-C下降20 mg/dL（P = 0.004）。每组均观察到平均LDL-C、TGs和BMI的变化，但无统计学意义。
尽管本分析中样本量较小限制了统计效力，但结果表明，在军事医疗中心将门诊患者转诊给临床药师治疗糖尿病和/或高脂血症可改善护理管理。
